Dry Eye Treatment

Dry eye syndrome (DES or dry eye) is a chronic lack of sufficient lubrication and moisture on the surface of the eye. Its consequences range from minor irritation to the inability to wear contact lenses and an increased risk of corneal inflammation and eye infections.

Signs and Symptoms of Dry Eye

Persistent dryness, scratchiness and a burning sensation on your eyes are common symptoms of dry eye syndrome. These symptoms alone may be enough for your eye doctor to diagnose dry eye syndrome. Sometimes, he or she may want to measure the number of tears in your eyes. A thin strip of filter paper placed at the edge of the eye, called a Schirmer test, is one way of measuring this.

Some people with dry eyes also experience a “foreign body sensation” – the feeling that something is in the eye. And it may seem odd, but sometimes dry eye syndrome can cause watery eyes because the excessive dryness works to overstimulate production of the watery component of your eye’s tears.

What Causes Dry Eyes?

In dry eye syndrome, the tear glands that moisturize the eye don’t produce enough tears, or the tears have a chemical composition that causes them to evaporate too quickly.

Dry eye syndrome has several causes. It occurs:

As a part of the natural aging process, especially among women over age 40.

As a side effect of many medications, such as antihistamines, antidepressants, certain blood pressure medicines, Parkinson’s medications, and birth control pills.

Because you live in a dry, dusty or windy climate with low humidity.

If your home or office has air conditioning or a dry heating system, that too can dry out your eyes. Another cause is insufficient blinking, such as when you’re staring at a computer screen all day.

Dry eyes are also associated with certain systemic diseases such as lupus, rheumatoid arthritis, rosacea or Sjogren’s Syndrome (a triad of dry eyes, dry mouth, and rheumatoid arthritis or lupus).

Long-term contact lens wear, incomplete closure of the eyelids, eyelid disease and a deficiency of the tear-producing glands are other causes.

Dry eye syndrome is more common in women, possibly due to hormone fluctuations. Recent research suggests that smoking, too, can increase your risk of dry eye syndrome. Dry eye has also been associated with incomplete lid closure following blepharoplasty – a popular cosmetic surgery to eliminate droopy eyelids.

Questions About Dry Eye:

Is it true that Dry Eye symptoms seem to be more severe in the winter than in the warmer spring and summer months?

Yes due to the low humidity outside and inside during winter.

We are inside more in the winter and the heat in your house can make your house very dry, heating systems like forced hot air can really cause dry eye.

When should a person come in to see their optometrist for Dry Eye symptoms and when is it enough to take care of this problem yourself?

As soon as you have any symptoms, they should come in and get tested. Some dry eye symptoms include foreign body sensation, burning, intermittent blurry vision, redness.

What is the examination like to determine whether someone is suffering from Dry Eyes?

Dry eye is very common, we use testing like dye tests to determine the extent of dry eye. We also examine the glands of the eyelid which can cause dry eye. Corneal Topography measures the front surface of your eye and uncovers signs of dry eye

I have a friend in whose eyes are frequently overly watery. That isn't Dry Eye, is it?

Patients with dry eye can, in fact, have watery eyes. The tear film is made up of three different components: water, lipids, and protein. If your tear film is lacking in lipids your tear film can evaporate and expose your cornea causing reflex tearing.

Can be if tears evaporate can cause reflex tearing

What are the typical treatments used to help people suffering from Dry Eyes?

Artificial tears are used usually first.

Advise patient stay hydrated by drinking water

Some studies have suggested that taking fish oil may help dry eye patients

For patients that have dry inflamed eyes, we may prescribe a short course of steroids drops followed by proper artificial teardrops

For those whose symptoms are not controlled by artificial tears, we may prescribe, Restasis or Xiidra, drink water, diet fish oils, or take Steroid drops.

Are some people more prone to having Dry Eyes than others?

As we age we older patients tend to have drier eyes. The glands in our eyelids tend not to produce enough tears

Patients who have inflamed or crusty eyelids may get dry eye easier.

Patients with rosacea tend to get dry eye.

Do you have any recommendations for people to help them avoid Dry Eye issues?

Drink plenty of water, add humidity to your house in the winter time. When you are driving don’t have the heat or air blowing in your face.

Treatment for Dry Eye

Dry eye syndrome is an ongoing condition that treatments may be unable to cure. But the symptoms of dry eye – including dryness, scratchiness and burning – can usually be successfully managed.

Your eyecare practitioner may recommend artificial tears, which are lubricating eye drops that may alleviate the dry, scratchy feeling and foreign body sensation of dry eye. Prescription eye drops for dry eye go one step further: they help increase your tear production. In some cases, your doctor may also prescribe a steroid for more immediate short-term relief.

Another option for dry eye treatment involves a tiny insert filled with a lubricating ingredient. The insert is placed just inside the lower eyelid, where it continuously releases lubrication throughout the day.

If you wear contact lenses, be aware that many artificial tears cannot be used during contact lens wear. You may need to remove your lenses before using the drops. Wait 15 minutes or longer (check the label) before reinserting them. For mild dry eye, contact lens rewetting drops may be sufficient to make your eyes feel better, but the effect is usually only temporary. Switching to another lens brand could also help.

Check the label, but better yet, check with your doctor before buying any over-the-counter eye drops. Your eye doctor will know which formulas are effective and long-lasting and which are not, as well as which eye drops will work with your contact lenses.

To reduce the effects of sun, wind and dust on dry eyes, wear sunglasses when outdoors. Wraparound styles offer the best protection.

Indoors, an air cleaner can filter out dust and other particles from the air, while a humidifier adds moisture to air that's too dry because of air conditioning or heating.

For more significant cases of dry eye, your eye doctor may recommend punctal plugs. These tiny devices are inserted in ducts in your lids to slow the drainage of tears away from your eyes, thereby keeping your eyes more moist.

Doctors sometimes also recommend special nutritional supplements containing certain essential fatty acids to decrease dry eye symptoms. Drinking more water may also offer some relief.

If medications are the cause of dry eyes, discontinuing the drug generally resolves the problem. But in this case, the benefits of the drug must be weighed against the side effect of dry eyes. Sometimes switching to a different type of medication alleviates the dry eye symptoms while keeping the needed treatment. In any case, never switch or discontinue your medications without consulting with your doctor first.

Treating any underlying eyelid disease, such as blepharitis, helps as well. This may call for antibiotic or steroid drops, plus frequent eyelid scrubs with an antibacterial shampoo.

If you are considering LASIK, be aware that dry eyes may disqualify you for the surgery, at least until your dry eye condition is successfully treated. Dry eyes increase your risk for poor healing after LASIK, so most surgeons will want to treat the dry eyes first, to ensure a good LASIK outcome. This goes for other types of vision correction surgery, as well.

Blephex

Over 50% of all patients suffer from some type of dry eye and blepharitis symptoms. BlephEx® is a new, in-office procedure that allows your doctor to take an active role in treating dry eye and blepharitis. An important step in treating meibomian gland dysfunction is debriding - or removing the excessive buildup of cells, debris and biofilm from the area around the meibomian glands - called Marx's line. Blephex helps to unblock the glands. The recently introduced BlephEx device is a gentle but extremely effective way of debriding the lid margins. This procedure is typically done every six months.